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The medical workers in Nigeria under the umbrella of JOHESU has called on the Presidency to kill the idea of Surgeon General in the country to allow peace reign in the health sector or witness a total closure of the nation’s hospitals.
This warning was handed over on 6th January 2014 during a press briefing by the union in Lagos. In a press release sent to us, they enumerated the problematic areas of the health sector as;

1. Post of Surgeon-General in Nigeria and Arbitrariness in the Health Sector
2. Skipping of CONHESS 10
3. Consultancy Status for Healthcare-Providers
4. Implementation of Agreements signed with Government since 2009
5. The National Health Bill
6. Amendment of Act 10 of 1985
7. National Health Insurance Scheme
8. Double Salary for Honorary Consultants

According to them “the information provided on the need for the post of the Surgeon-General cannot be a compelling factor to waste scarce public funds for an ego trip. The precedence of a Surgeon-General draws its parallel from only the U.S.A. It is not the norm in any other part of the world. The best in terms of ranking ever achieved by a Surgeon-General was as an Assistant Secretary of Health. Today the incumbent Surgeon-General reports to an Assistant Secretary of Health in the United States which promotes the concept.
It is instructive to note that the office of the Assistant Secretary of Health to which the Surgeon General reports in the U.S.A. is junior to the Minister of State for Health in Nigeria.” They further noted that creating such an office will be a duplication of the Minister of Health, since there is a director of Public Health under the ministry. Their refusal also stemmed from the fact that the bill has already been rejected by the 6th National Assembly as well as the Justice Abdullahi Gusau Committee on Harmony in the Health Sector.
They berated Olukoye Kuti who created the Medical Salary Scale in the nineties which is the bane of the health sector today. The statement wonders why a Medical Doctor should earn 200% salary above his colleague in any sector. “The insistence that other health worker must not be allowed to skip CONHESS 10 which is now a major demand in the quest to placate Doctors not to go on strike is a national embarrassment and fraud. Doctors are now demanding to enter the public service on salary GL 14 after National Youth Service.”

They urge the government to respect the court ruling which allows for them to skip CONHESS 10. The Medical workers asked the government to immediately obey the court judgment on the issue of consultancy which was stopped. They wonder why there can be no consultant in other medical field when they are specialized professionals, just as it obtains in other parts of the world.

They bemoaned as situation where ‘the promotion of our members has been withheld for decades. Professional regulatory laws and service circulars continue to be recklessly compromised by the Federal Government working on the advice of the Federal Ministry of Health, like we recently witnessed again at NAFDAC for instance where the Director-General of the Agency has been re-appointed in flagrant violation of Section 9 of the enabling NAFDAC Act which provides inter-alia that the Director General “must have a good knowledge of PHARMACY, FOOD and DRUGS”.

Further they urged the government to implement the new wages and call duty allowance. The issue of the National Health Bill according to them contradicts the constitution, especially some paragraph which vested power on it to regulate the medical profession when an act has been passed vesting such powers on the various medical boards.

They demanded for the amendment of the act coined by Kuti. “The foundation for all the years of injustice in the health sector is grounded in the military drafted Teaching Hospital Act 10 of 1985, a creation of Late Olikoye Kuti. The statute facilitates imbalance in board appointments in favour of doctors, stagnation in the career strata of health workers as well as other exclusive privileges for doctors in a multi-disciplinary sector”, it stated

The statement exposed that consultants in the medical and dental council earn double salary as honorary consultants since they are University employees but also collect money from the teaching hospitals where they come once a week to choose patients to treat. They therefore called on the government to privatize medical services in private hospitals.

“We put on record that 50% of total health budget is dedicated to the payment of only consultant doctors in Federal Health Institutions. This is the main reason why Nigerian Medical Association and Medical and Dental Consultants of Nigeria continue to agitate against Integrated Personal Pay Roll System (IPPRS) because it subsequently will detect those who earn double salary. Government therefore needs to privatize medical services in public hospitals in Nigeria.”

They asked for a meeting with Mr. President who is the father of the nation to enable them air their views, while a fifteen days ultimatum was given to the government to meet their demands.

Consequent upon this and the expiration of the 15 day ultimatum earlier given, the Joint Health Sector Unions and the Assembly of Healthcare Professionals of Nigeria in league after appraising all its options painfully direct all its members to proceed on a 5-day warning strike from Wednesday January 15 to Tuesday January 21, 2014 to enable government led personally by President Goodluck Jonathan redress through constructive dialogue its prayer/grievances as reflected in this position paper which shall be made available to government. The condition precedent to dialogue with President Jonathan is a minimum conditionality which is also non-negotiable as the President who is the father of the nation must be willing to give all his children a listening ear in a conflict that continues to fester as a rotten and infected wound because the future of healthcare-providers in Nigeria can no longer be left with Presidential aides who find it difficult to disguise their affection for the interest of only one profession in a multi-disciplinary sector.

In the event that Government does not enter into meaningful dialogue within two weeks of this notice, we shall be left with no option than to commence a more excruciating and total nationwide strike to enforce our liberties.

Memo Issued by the Assembly of Healthcare Professionals and Joint Health Sector Unions to His Excellency,Dr. Goodluck Jonathan dated January 6, 2014

His Excellency,
Dr. Goodluck Jonathan, GCFR

Your Excellency,

GIRDING OUR LOINS FOR
PROFESSIONAL SURVIVAL

Recent events have compelled a need to write your excellency. In the
last few weeks our sensibilities as
healthcare workers has been traumatized by doctors who have more affinity for strikes than to save lives.

Government appears to have wittingly compounded the situation by conceding priviledges to one profession, while refusing to implement valid court orders in favour of other health professions.

We shall contextualize this memo under the following sub heads to enable you appreciate the issues
at hand:

1) POST OF SURGEON-GENERAL IN NIGERIA
2) skiping of CONHESS 10
3) Consultancy status for healthcare providers
4) Implementation of agreements signed with government since 2009
5) The national health bill
6) amendment of act 10 of 1985
7) National health insurance scheme
8) double salary for honorary consultants
9) Appointment of health minister
10) Participation in national institute of policy and strategic studies kuru
managment course
11) representatives on national dialogue

PRAYERS/ GRIEVANCES
1) immediate circularization of the approval of consultancy status for
some cadres of health workers and payment of the arrears of all honorary consultants appointed by
the boards of management of hospitals which wwere arbitrarily stopped on the directive of the minister of health. This is in line with
due process as dictated by the pronouncment of the national industrial court in july 2003 and the subsequent agreement of the representatives of JOHESU and other
representatives of professional bodies in the health sector in august
2013
2) The release of official circulars to enforce the decision of national
industrial court that some cadres of the health workforce be legitimately
allowed to skip CONHESS 10. The federal government/ presidency must subsequently direct the boards of management of all hospitals to enforce this directive in their domains
3) A presidential directive compelling the National salary and wages
commission to negotiatie and approve reasonalbe and respectable allowances as well as emoluments for health workser in nigeria.
4) An unconditional halt to the appointment of a surgeon general for the federation as the concept
remains both unconstitutional and outrightly unlawful. Government is advised to remember the consequences of the unlawful Medical salary scale of the nineties which is the precursor of the
industrial disharmony in public service where different cadres of workers agitate for discriminatory
and exclusive wages. The move to appoint a surgeon general will lead to demands for such by all cadres of workers and therefore makes government more vulneralbe to strikes and shut downs in the months ahead.
5) In view of parlours state of our health, government must redress the other areas of injustice in the health sector once and for all. This will include:
a) Amendment of the extremely obnoxious decree 10 of 1985 which
laid the foundation for oppression in the health sector through appointment unduly skewed in favour of nigeria doctors contrary to
international best practices through an executive bill.
b) rederessing the extremely wretched output of the national insurance scheme which has provided cover for less than 3% of the citizenry in 15 years under the poor management styles of doctors who have been appointed executive
secretaries int he last 8 years.specifically, government must
lawfully implement payment mechanisms for health care staff by doing away with global capitation
and capitating only primary care centers for the dream of universal coverage to see the light of day.
c) an immediate evaluation of the draft national health bill through an outright deletion of the potentially dangerous section 1(1)
which provides that a national health system will regulate and control all the health profession". This provision is in conflict with
existing provisions in all the
enalbing acts that regulates the plethora of health professions in Nigeria. It is an obvious booby trap to subordinate other health
professions to medicine and therefore remanis unacceptable to the generality of care providers. The unconstitutional provision in section 9 of the draft bill which vests the headship of the proposed national standards committee of tertiary hospitals on the director of hospital services at the federal ministry of health negates the spirit of any reform agenda which is usually for a departure from the status quo. it is also a breach of section 42 of the federal constitution which forbids a denial of a priviledge that can be
enjoyed by a citizen of nigeria on the basis of sexual, social,religious or related affiliation.
6) Rejuvenation of a well funded and properly positioned presidential
committee of experts on harmony in the health sector for a permanent and equitable structure in the
priviledges of all care providers in nigeria
7) A commitment that your
excellency will no longer appoint the two ministers in charge of the federal
ministry of health from only one profession in a multidisciplinary sector as witnessed in the present
dispensation. The imbalance in the headship of the federal ministry of
health has encouraged impounity ad infinitous in the last few years.
8) Privatisation of medical services to free funds for capital expenditure
especially research and development in health sector.
9) A presidential intervention to regularize the participation of health
professional bodies and sector unions in the senior management courses of the NIPSS, kuru as was the
practise hitherto.
10) Nomination of representatives of health professional bodies to
participate in the national dialogue/ constitutional reforms planned for
february, 2014

CONCLUSION/ DECLARATION It has become imperative to declare on this unique occassion that care providers in nigeria will not
surrender their inalienable right to liberty, fairness, equity and justice under whatever circumstance. No one will be allowed to ride on us roughshod in the health sector, be they elected or appointed
representative of nigerians or any component of the health sector which we subscribe to will be all allowed the luxury of misadventure to perpetuate tyranny and unwholesome dominion in our sector anymore.

consequent upon this the assembly of healthcare professionals of nigeria and joint health sector unions in league after appraising all its options painfully directs all its members to proceed on a 5 day warning strike from wednesday january 15th to enable government led personally by your excellency redress through constructive dialogue its prayer/grievances as reflected in this positon paper which shall be made available to government.

The condition precedent to dialogue with your excellency is a minimum conditionality which is also non negotiable as the president who is the father of the nation must be willing to give all his children a listening ear in a conflict that continues to fester as a rotten and
infected wound because the future of care providers in nigeria can no longer be left with presidentail aides
who find it difficult to disguise their affection for the interest of only one
profession in a multi disciplinary sector.

In the event that your excellency does not enter into meaningful dialogue
within two weeks of this notice,we shall be left with no option than to commence a more excruciating and total nationwide strike to enforce our liberties.

We call on all men of goodwill to admonish government on the need
to urgently redress this avoidable crisis it has also assisted to worsen.

Finally, we urge all our colleagues and comrades to stand up to be counted as we resist the flagrant
assalut on the soul of our
professional callings.